White House Delays Part Of Health Care Law

The Obama administration is delaying the start of a key piece of the Affordable Care Act, the national health care law. Workers in small businesses will have to wait an additional year to be able to choose from more than one plan in the new, online marketplace that starts next January. NPR's Julie Rovner reports that the change might dampen enthusiasm - at least, at the start. But not everyone thinks that's a bad thing.

JULIE ROVNER, BYLINE: OK. First, these health exchanges people have been talking about, where individuals and small businesses will be able to go and shop for insurance in every state, starting next year? Well, they're actually two, separate pools, says John Arensmeyer. He's founder and CEO of the group Small Business Majority.

JOHN ARENSMEYER: The exchange is a unified entity but in every case, it includes both an individual exchange and a small-business exchange.

ROVNER: Starting this October, when enrollment opens, individuals will have a choice of plans to choose from. But it turned out that giving employees of small businesses the ability to choose from more than one plan, was harder to figure out. So the Obama administration has decided to let small employers purchase coverage through the exchange, but their workers won't be able to select different plans. That's pretty much the way small-business health insurance works now - the boss chooses your insurance. And Arensmeyer says it's a big disappointment.

ARENSMEYER: A major selling point of the small-business exchange is that small-business owners will be able to simply select a particular level of coverage that they want their employees to have, and then their employees will have the ability to choose from multiple plans within that level of coverage.

ROVNER: Without that ability to offer multiple plans, Arensmeyer says...

ARENSMEYER: It will be less attractive.

ROVNER: And so fewer business owners may join the exchanges - at least, at first. Now, there are a couple of important points to remember. One is that this delay doesn't necessarily apply to every state exchange, just those being set up and run by the federal government - although that's most of them.

At the same time, Jay Angoff, a former Obama health official, says the delay isn't that big a deal; that when the exchanges begin offering multiple plans is less important than whether they do what they were designed for. Angoff says he's all for giving the government more time to make sure that the plans compete to offer the best coverage at the lowest possible price.

JAY ANGOFF: And I do think that if it results in the exchanges using their bargaining power, establishing a competitive bidding process, that it's a good thing - not a bad thing - because it will give the exchanges more time to set up a process which will force insurance companies either to charge reasonable rates, or not sell through the exchanges at all.

ROVNER: Joel Ario, another former Obama health official now back in the private sector, says he won't be surprised if opponents of the law see the delay as the first indication that the Department of Health and Human Services won't be able to meet its deadlines. But he doesn't think that's the case.

JOEL ARIO: I think it shows that the agency is going to focus on the must-dos; and the nice-to-haves will have to, in some cases, wait. And this is one of those, it would be nice to have, but we - not essential for 2014.

ROVNER: Small businesses that support the law will still have a reason to join when the exchanges first go live next year. If they do, they could be eligible for new tax credits that can lower the cost of providing coverage. But it's definitely another bump in the road for a law that's seen its share.